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**SNTA <br />NA,ffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />INSP,O2 2013 CRC <br />This document may be Jound ot.h ttp://',,nm,v. sa nta -a na. o rq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:1CI41 il breatleal *,6a,fun a,(k. <br />Permit Number:ctqrob, <br />Property Owner:rCa ?e(uy, <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b uild ings. <br />California Residential Code (CRC) Settion R31+.1and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations, <br />A go,n boxes below must be checked: <br />{ CarUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />V <br />E Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />room, and on each level of the dwelling. <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations are <br />performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved <br />by the State Fire Marshall (SFM). Battery life must be 10 years. <br />I hereby certify that I am the contractor or the property owner of the above project. I further certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per the <br />m an ufacturer's instructions. <br />(check onel icen sed Contractor F\ Property Owner <br />NOTE: Ihis sef-certificdtion is only used for projects that ollect the EXTERIOR of the structure. This <br />process is applicoble ONLY to projects where occess to the interior of the dwelling by o Sonto And <br />lnspector is not required. <br />Contractor:r,,\) eat["r l,ne Rerdr^ r P*f.l icense #: ,l337lC <br />4'A/i^^-'/ liSignoture:r1z I i$ <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />ww.r',/. santa-an a.orq <br />I <br />I <br />I <br />l <br />\ <br />Dote: <br />tr